Mivacurium Infusion Requirements in Pediatric Surgical Patients During Nitrous Oxide-Halothane and During Nitrous Oxide-Narcotic Anesthesia
| Autor: | M. L. Dong, V. J. Foster, Barbara McNulty, Barbara W. Brandom, Lawrence M. Borland, David R. Cook, Michael Horn, J. B. Sarner, J. N. Weakly, Susan K. Woelfel |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Narcotic
medicine.medical_treatment Scopolamine Neuromuscular Junction Nitrous Oxide Pediatrics chemistry.chemical_compound medicine Humans Child Infusions Intravenous Ulnar nerve Neuromuscular Blockade Diazepam Morphine Inhalation business.industry Nitrous oxide Isoquinolines Adductor pollicis muscle Mivacurium Anesthesiology and Pain Medicine chemistry Butyrylcholinesterase Child Preschool Anesthesia Anesthetic Methohexital Halothane Anesthesia Inhalation business Neuromuscular Nondepolarizing Agents medicine.drug |
| Zdroj: | Anesthesia & Analgesia. 71:16 |
| ISSN: | 0003-2999 |
| DOI: | 10.1213/00000539-199007000-00003 |
| Popis: | We were interested in determining the infusion rate of mivacurium required to maintain approximately 95% neuromuscular blockade during nitrous oxide-halothane (0.8% end-tidal) or nitrous oxide-narcotic anesthesia. Neuromuscular blockade was monitored by recording the electromyographic activity (Datex NMT) of the adductor pollicis muscle resulting from supramaximal stimulation of the ulnar nerve at 2 Hz for 2 s at 10-s intervals. Mivacurium steady-state infusion requirements averaged 315 +/- 26 micrograms.m-2.min-1 during nitrous oxide-halothane anesthesia and 375 +/- 19 micrograms.m-2.min-1 (mean +/- SEM) during nitrous oxide-narcotic anesthesia. Higher levels of pseudocholinesterase activity were generally associated with a higher mivacurium infusion requirement. During both anesthetics, younger age was associated with a higher infusion requirement when the infusion requirement was calculated in terms of micrograms.kg-1.min-1. This difference was not present when the infusion rate was calculated in terms of micrograms.m-2.m-1. There was no evidence of cumulation during prolonged mivacurium infusion. There was no difference in the rates of spontaneous or reversal-mediated recovery between anesthetic groups. After the termination of the infusion, spontaneous recovery to T4/T1 greater than or equal to 0.75 occurred in 9.8 +/- 0.4 min, with a recovery index, T25-75, of 4.0 +/- 0.2 min (mean +/- SEM). In summary, pseudocholinesterase activity is the major factor influencing mivacurium infusion rate in children during nitrous oxide-narcotic or nitrous oxide-halothane (0.8% end-tidal) anesthesia. |
| Databáze: | OpenAIRE |
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